This project uses classical epidemiology, molecular epidemiology and precision medicine. As the main causes of the disparities in incidence are unknown, we are conducting population studies to assess the potential causes. We examine heterogeneity in exposures between European Americans and African Americans. Understanding such differences could provide clues for etiology, prevention and new treatments. Secondly, we are conducting molecular epidemiology studies of blood-based proteins and examining cytokine profiles in these populations. Our ongoing work shows that cytokine profiles are promising risk, diagnostic and prognostic biomarkers. We are also currently undertaking a comprehensive molecular analysis of lung cancer tissues from European Americans and African Americans and building a precision medicine atlas of lung cancer in African Americans. These samples are being analysed for microRNA, coding gene expression, genetics and methylation. The goals of these analyses are to understand whether differences in tumor biology exist in lung cancers from African Americans and European Americans. The differences that we have found could be leveraged to improve patient outcomes.